Search tips
Search criteria 


Logo of annrheumdAnnals of the Rheumatic DiseasesVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Ann Rheum Dis. 1994 February; 53(2): 90–93.
PMCID: PMC1005258

Occupational activity and osteoarthritis of the knee.


OBJECTIVES--To test the hypothesis that specific occupational physical activities are risk factors for knee osteoarthritis (OA). METHODS--A population-based case-control study of knee osteoarthritis was carried out in which 109 men and women with painful, radiographically confirmed knee OA were compared with 218 age and sex matched controls who had not suffered knee pain and had normal radiographs. Information collected included a lifetime occupational history and details of specific workplace physical activities. RESULTS--After adjustment for obesity and Heberden's nodes, the risk of knee OA was significantly elevated in subjects whose main job entailed more than 30 minutes per day squatting (OR 6.9, 95% CI 1.8-26.4) or kneeling (OR 3.4, 95% CI 1.3-9.1), or climbing more than ten flights of stairs per day (OR 2.7, 95% CI 1.2-6.1). The increase in risk associated with kneeling or squatting appeared to be more marked in subjects whose jobs entailed heavy lifting, but the size of the study did not permit precise delineation of any such interaction. CONCLUSIONS--These data suggest that prolonged or repeated knee bending is a risk factor for knee OA, and that risk may be higher in jobs which entail both knee bending and mechanical loading.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (811K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987 Aug;30(8):914–918. [PubMed]
  • Davis MA, Ettinger WH, Neuhaus JM, Cho SA, Hauck WW. The association of knee injury and obesity with unilateral and bilateral osteoarthritis of the knee. Am J Epidemiol. 1989 Aug;130(2):278–288. [PubMed]
  • Felson DT. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev. 1988;10:1–28. [PubMed]
  • Anderson JJ, Felson DT. Factors associated with osteoarthritis of the knee in the first national Health and Nutrition Examination Survey (HANES I). Evidence for an association with overweight, race, and physical demands of work. Am J Epidemiol. 1988 Jul;128(1):179–189. [PubMed]
  • Felson DT, Hannan MT, Naimark A, Berkeley J, Gordon G, Wilson PW, Anderson J. Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study. J Rheumatol. 1991 Oct;18(10):1587–1592. [PubMed]
  • Kivimäki J, Riihimäki H, Hänninen K. Knee disorders in carpet and floor layers and painters. Scand J Work Environ Health. 1992 Oct;18(5):310–316. [PubMed]
  • McAlindon TE, Snow S, Cooper C, Dieppe PA. Radiographic patterns of osteoarthritis of the knee joint in the community: the importance of the patellofemoral joint. Ann Rheum Dis. 1992 Jul;51(7):844–849. [PMC free article] [PubMed]
  • McAlindon TE, Cooper C, Kirwan JR, Dieppe PA. Knee pain and disability in the community. Br J Rheumatol. 1992 Mar;31(3):189–192. [PubMed]
  • Croft P, Cooper C, Wickham C, Coggon D. Osteoarthritis of the hip and occupational activity. Scand J Work Environ Health. 1992 Feb;18(1):59–63. [PubMed]
  • Radin EL, Paul IL, Rose RM. Role of mechanical factors in pathogenesis of primary osteoarthritis. Lancet. 1972 Mar 4;1(7749):519–522. [PubMed]
  • Radin EL, Ehrlich MG, Chernack R, Abernethy P, Paul IL, Rose RM. Effect of repetitive impulsive loading on the knee joints of rabbits. Clin Orthop Relat Res. 1978 Mar-Apr;(131):288–293. [PubMed]
  • Gray ML, Pizzanelli AM, Grodzinsky AJ, Lee RC. Mechanical and physiochemical determinants of the chondrocyte biosynthetic response. J Orthop Res. 1988;6(6):777–792. [PubMed]
  • van Kampen GP, Veldhuijzen JP, Kuijer R, van de Stadt RJ, Schipper CA. Cartilage response to mechanical force in high-density chondrocyte cultures. Arthritis Rheum. 1985 Apr;28(4):419–424. [PubMed]
  • Alexander C. Flexion angles of the knee in different resting positions and their relation to the prevalence of osteoarthritis. J Rheumatol. 1991 Aug;18(8):1223–1226. [PubMed]
  • Cooper C, Cushnaghan J, Kirwan JR, Dieppe PA, Rogers J, McAlindon T, McCrae F. Radiographic assessment of the knee joint in osteoarthritis. Ann Rheum Dis. 1992 Jan;51(1):80–82. [PMC free article] [PubMed]
  • Davis MA, Ettinger WH, Neuhaus JM, Hauck WW. Sex differences in osteoarthritis of the knee. The role of obesity. Am J Epidemiol. 1988 May;127(5):1019–1030. [PubMed]
  • Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med. 1988 Jul 1;109(1):18–24. [PubMed]
  • Spector TD. The fat on the joint: osteoarthritis and obesity. J Rheumatol. 1990 Mar;17(3):283–284. [PubMed]
  • KELLGREN JH, LAWRENCE JS. Rheumatism in miners. II. X-ray study. Br J Ind Med. 1952 Jul;9(3):197–207. [PMC free article] [PubMed]
  • Partridge RE, Duthie JJ. Rheumatism in dockers and civil servants. A comparison of heavy manual and sedentary workers. Ann Rheum Dis. 1968 Nov;27(6):559–568. [PMC free article] [PubMed]
  • Lindberg H, Montgomery F. Heavy labor and the occurrence of gonarthrosis. Clin Orthop Relat Res. 1987 Jan;(214):235–236. [PubMed]
  • Kohatsu ND, Schurman DJ. Risk factors for the development of osteoarthrosis of the knee. Clin Orthop Relat Res. 1990 Dec;(261):242–246. [PubMed]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Group